Lymphoma FLASHCARDS

*Question: What is the gold standard diagnostic procedure for lymphoma?
A) Fine-needle aspiration
B) Excisional biopsy
C) Bone marrow biopsy
D) Flow cytometry

*Answer: B) Excisional biopsy

*Question: Which lymphoma is characterized by the presence of Reed-Sternberg cells?
A) Diffuse Large B-Cell Lymphoma
B) Follicular Lymphoma
C) Hodgkin Lymphoma
D) Burkitt Lymphoma

*Answer: C) Hodgkin Lymphoma

*Question: What is the most common form of Non-Hodgkin Lymphoma?
A) Follicular Lymphoma
B) Mantle Cell Lymphoma
C) Burkitt Lymphoma
D) Diffuse Large B-Cell Lymphoma

*Answer: D) Diffuse Large B-Cell Lymphoma

*Question: Which virus is associated with Adult T-cell Leukemia/Lymphoma?
A) EBV
B) HIV
C) HTLV-1
D) HCV

*Answer: C) HTLV-1

*Question: What is the second most common Non-Hodgkin Lymphoma?
A) Mantle Cell Lymphoma
B) Follicular Lymphoma
C) Burkitt Lymphoma
D) Marginal Zone Lymphoma

*Answer: B) Follicular Lymphoma

*Question: Which of the following is NOT a B symptom of lymphoma?
A) Unexplained weight loss >10% BW in 6 months
B) Recurrent drenching night sweats
C) Painless lymphadenopathy
D) Unexplained persistent fever >38°C

*Answer: C) Painless lymphadenopathy

*Question: What is the standard of care treatment for DLBCL?
A) MOPP
B) ABVD
C) R-CHOP
D) CHOP alone

*Answer: C) R-CHOP

*Question: Which gene mutation is most characteristic of Burkitt Lymphoma?
A) BCL2
B) BCL6
C) MYC
D) Cyclin D1

*Answer: C) MYC

*Question: What is the hallmark morphologic finding of Burkitt Lymphoma on biopsy?
A) Popcorn cells
B) Starry sky pattern
C) Pautrier microabscesses
D) Paratrabecular distribution

*Answer: B) Starry sky pattern

*Question: What is the immunophenotype of Reed-Sternberg cells in Classic Hodgkin Lymphoma?
A) CD30+, CD15+
B) CD30+, CD15-
C) CD20+, CD15+
D) CD3+, CD4+

*Answer: A) CD30+, CD15+

*Question: Which staging system is primarily used for Non-Hodgkin Lymphoma?
A) Ann Arbor
B) Lugano
C) FLIPI
D) MIPI

*Answer: B) Lugano

*Question: Which staging system is primarily used for Hodgkin Lymphoma?
A) Lugano
B) FLIPI
C) Ann Arbor
D) IPI

*Answer: C) Ann Arbor

*Question: What is the lifetime risk of developing ATLL in HTLV-1 carriers?
A) 1%
B) 5%
C) 10%
D) 15%

*Answer: B) 5%

*Question: Which subtype of ATLL has the worst prognosis with a median survival of 8 months?
A) Smoldering
B) Chronic
C) Leukemic phase
D) Acute

*Answer: D) Acute

*Question: What is the characteristic cell morphology seen in the leukemic phase of ATLL?
A) Starry sky cells
B) Flower cells
C) Popcorn cells
D) Villous lymphocytes

*Answer: B) Flower cells

*Question: Which organism is classically associated with MALT lymphoma of the stomach?
A) H. influenzae
B) H. pylori
C) Hepatitis C virus
D) EBV

*Answer: B) H. pylori

*Question: What is the most common subtype of Marginal Zone Lymphoma?
A) Splenic MZL
B) Nodal MZL
C) MALT lymphoma
D) Extranodal MZL

*Answer: C) MALT lymphoma

*Question: Which infection is associated with Nodal Marginal Zone Lymphoma?
A) H. pylori
B) HTLV-1
C) Hepatitis C
D) EBV

*Answer: C) Hepatitis C

*Question: What is the characteristic morphologic finding of Follicular Lymphoma cells?
A) Distinct vacuoles
B) Cerebriform nucleus
C) Deep nuclear clefts at sharp angles
D) Abundant cytoplasm with prominent nucleoli

*Answer: C) Deep nuclear clefts at sharp angles

*Question: Where do tumor cells localize in bone marrow biopsy of Follicular Lymphoma?
A) Intrasinusoidal
B) Paratrabecular
C) Interstitial
D) Diffuse

*Answer: B) Paratrabecular

*Question: Which grade of Follicular Lymphoma has the poorest outcome?
A) Grade 1
B) Grade 2
C) Grade 3A
D) Grade 3B

*Answer: D) Grade 3B

*Question: What translocation is diagnostic of Mantle Cell Lymphoma?
A) t(14;18)
B) t(8;14)
C) t(11;14)
D) t(9;22)

*Answer: C) t(11;14)

*Question: What alternate marker is used to diagnose MCL when Cyclin D1 is negative?
A) BCL2
B) SOX11
C) MYC
D) CD10

*Answer: B) SOX11

*Question: What is the most common extranodal site involved in Mantle Cell Lymphoma?
A) Skin
B) Testis
C) GI tract
D) CNS

*Answer: C) GI tract

*Question: Which DLBCL subtype has a more favorable prognosis?
A) Activated B-cell subtype
B) Non-germinal center DLBCL
C) Germinal center DLBCL
D) Triple-hit DLBCL

*Answer: C) Germinal center DLBCL

*Question: What is the Triple Hit designation in DLBCL?
A) BCL2 + BCL6 + MYC rearrangements
B) MYC + BCL2 +/- BCL6 rearrangements
C) CD10 + BCL6 + MUM1
D) MYC + CD30 + BCL6

*Answer: B) MYC + BCL2 +/- BCL6 rearrangements

*Question: Which DLBCL subtype is treated with BTK inhibitors?
A) Germinal center DLBCL
B) Triple-hit DLBCL
C) Non-germinal center (activated B-cell) DLBCL
D) Burkitt-like DLBCL

*Answer: C) Non-germinal center (activated B-cell) DLBCL

*Question: What is the most common form of cutaneous T-cell lymphoma?
A) Sézary Syndrome
B) ATLL
C) ALCL
D) Mycosis Fungoides/Sézary Syndrome

*Answer: D) Mycosis Fungoides/Sézary Syndrome

*Question: What is the characteristic nuclear morphology of MF/SS cells?
A) Bilobed nucleus
B) Cerebriform/folded nucleus
C) Folded single nucleus (popcorn)
D) Binucleated with owl-eye nucleoli

*Answer: B) Cerebriform/folded nucleus

*Question: Where do atypical cells localize in Mycosis Fungoides?
A) Bone marrow
B) Peripheral blood
C) Pautrier microabscesses in the epidermis
D) Germinal centers

*Answer: C) Pautrier microabscesses in the epidermis

*Question: Which form of MF/SS primarily involves the peripheral blood and has worse prognosis?
A) Mycosis Fungoides
B) Sézary Syndrome
C) Leukemic phase
D) Smoldering form

*Answer: B) Sézary Syndrome

*Question: What minimum CD4/CD8 ratio is required for Sézary Syndrome diagnosis?
A) 4 or greater
B) 6 or greater
C) 10 or greater
D) 15 or greater

*Answer: C) 10 or greater

*Question: What absolute Sézary cell count in peripheral blood is required for SS diagnosis?
A) >500 cells/µL
B) >1,000 cells/µL
C) >2,000 cells/µL
D) >5,000 cells/µL

*Answer: B) >1,000 cells/µL

*Question: What is the only treatment with potential cure for Mycosis Fungoides/Sézary Syndrome?
A) R-CHOP
B) Phototherapy
C) HSCT
D) Rituximab

*Answer: C) HSCT

*Question: What is the key surface marker of Anaplastic Large Cell Lymphoma?
A) CD20
B) CD15
C) CD30
D) CD10

*Answer: C) CD30

*Question: Which ALCL subtype is associated with breast implants?
A) ALK+
B) ALK-
C) Both ALK+ and ALK-
D) CD30+ subtype

*Answer: B) ALK-

*Question: Which ALCL subtype has better prognosis and is seen in younger individuals?
A) ALK-
B) ALK+
C) CD30-
D) EBV-associated

*Answer: B) ALK+

*Question: What monoclonal antibody is used for relapsed ALCL?
A) Rituximab (anti-CD20)
B) Mogamulizumab (anti-CCR4)
C) Brentuximab (anti-CD30)
D) Nivolumab (anti-PD1)

*Answer: C) Brentuximab (anti-CD30)

*Question: Which immunophenotype is characteristic of PTCL-NOS?
A) CD3+, CD4+, CD25+
B) CD7-, CD5-
C) CD30+, CD15+
D) CD10+, BCL6+

*Answer: B) CD7-, CD5-

*Question: Classic Hodgkin Lymphoma accounts for what percentage of all HL cases?
A) 75%
B) 85%
C) 95%
D) 100%

*Answer: C) 95%

*Question: What is the age distribution pattern of Classic Hodgkin Lymphoma?
A) Unimodal peak at age 30
B) Bimodal: 30s and after 50 years old
C) Only affects elderly >65 years
D) Peaks in childhood and adolescence

*Answer: B) Bimodal: 30s and after 50 years old

*Question: What are the hallmark cells of Nodular Lymphocyte Predominant HL?
A) Reed-Sternberg cells
B) Flower cells
C) Lymphocytic histiocytic (popcorn) cells
D) Sézary cells

*Answer: C) Lymphocytic histiocytic (popcorn) cells

*Question: What is the immunophenotype of NLPHL?
A) CD30+, CD15+, EMA-
B) CD30-, CD15-, EMA+ (50%)
C) CD20-, CD30+
D) CD3+, CD4+, CD8-

*Answer: B) CD30-, CD15-, EMA+ (50%)

*Question: What is the first-line chemotherapy regimen for Hodgkin Lymphoma?
A) R-CHOP
B) MOPP → ABVD
C) BR
D) CHOP

*Answer: B) MOPP → ABVD

*Question: What immunotherapy is used for relapsed HL after HSCT?
A) Rituximab
B) Brentuximab
C) PD-1 inhibitors (nivolumab/pembrolizumab)
D) Mogamulizumab

*Answer: C) PD-1 inhibitors (nivolumab/pembrolizumab)

*Question: Which investigation is used to determine clonality in B-cell lymphomas?
A) Flow cytometry
B) Light chain restriction on immunophenotyping
C) FISH
D) Molecular testing

*Answer: B) Light chain restriction on immunophenotyping

*Question: Which imaging modality is more sensitive and provides greater localization in lymphoma staging?
A) CT scan
B) MRI
C) PET with FDG
D) Ultrasound

*Answer: C) PET with FDG

*Question: What does biochemical analysis indirectly measure in lymphoma workup?
A) Lineage of cells
B) Degree of maturation
C) Tumor burden
D) Clonality

*Answer: C) Tumor burden

*Question: Which Ann Arbor stage involves nodes on both sides of the diaphragm?
A) Stage I
B) Stage II
C) Stage III
D) Stage IV

*Answer: C) Stage III

*Question: What defines Stage IV in Ann Arbor staging?
A) Nodes on both sides of diaphragm
B) ≥2 nodes same side of diaphragm
C) Diffuse involvement of ≥1 extralymphatic organ
D) Single extranodal site

*Answer: C) Diffuse involvement of ≥1 extralymphatic organ

*Question: In the IPI, which LDH level indicates adverse prognosis?
A) Below normal
B) At normal
C) Above normal
D) Any abnormal level

*Answer: C) Above normal

*Question: What IPI score range corresponds to the High risk group?
A) 0-1
B) 2
C) 3
D) 4-5

*Answer: D) 4-5

*Question: Which Follicular Lymphoma grade has the criterion of centrocytes being absent?
A) Grade 1
B) Grade 2
C) Grade 3A
D) Grade 3B

*Answer: D) Grade 3B

*Question: What is the characteristic spread pattern of Hodgkin Lymphoma?
A) Non-contiguous, skipping lymph node groups
B) Hematogenous spread
C) Contiguous spread
D) Direct extension to extranodal sites

*Answer: C) Contiguous spread

*Question: What percentage of NHL does Mantle Cell Lymphoma comprise?
A) 2%
B) 6%
C) 10%
D) 15%

*Answer: B) 6%

*Question: What is the median age of diagnosis for Mantle Cell Lymphoma?
A) 50 years old
B) 58 years old
C) 68 years old
D) 75 years old

*Answer: C) 68 years old

*Question: Which Burkitt Lymphoma subtype is associated with EBV genome?
A) Sporadic
B) Immunodeficiency-associated
C) Endemic
D) All subtypes

*Answer: C) Endemic

*Question: What organs are characteristically involved in Endemic Burkitt Lymphoma?
A) Abdomen and CNS
B) Orbit and mandible
C) Skin and bone marrow
D) Spleen and liver

*Answer: B) Orbit and mandible

*Question: In Sporadic Burkitt Lymphoma, what percentage of patients have bone marrow infiltration?
A) 30%
B) 50%
C) 70%
D) 90%

*Answer: C) 70%

*Question: Which flow cytometry finding defines the degree of maturation in lymphoid neoplasms?
A) Light chain restriction
B) Immunophenotyping
C) Flow cytometry
D) FISH analysis

*Answer: C) Flow cytometry

*Question: What is the IL-2 used as in ATLL?
A) Treatment target
B) Staging marker
C) Tumor marker for disease status
D) Diagnostic marker for lineage

*Answer: C) Tumor marker for disease status

*Question: Which ATLL subtype involves aggressive extensive extranodal involvement of peripheral blood and skin?
A) Smoldering
B) Chronic
C) Leukemic phase
D) Acute

*Answer: D) Acute

*Question: What is the ATLL immunophenotype marker that is NEGATIVE?
A) CD3
B) CD4
C) CD8
D) CD25

*Answer: C) CD8

*Question: Which drug combination is used against HTLV-1 virus in ATLL treatment?
A) R-CHOP
B) Interferon-alpha + AZT
C) ABVD
D) BR

*Answer: B) Interferon-alpha + AZT

*Question: What is the primary site of disease in Non-Hodgkin Lymphoma?
A) Bone marrow and peripheral blood
B) Thymus and spleen
C) Lymph nodes and spleen
D) Liver and lungs

*Answer: C) Lymph nodes and spleen

*Question: Splenic MZL accounts for what percentage of NHL?
A)

*Answer: A)

*Question: What is the characteristic peripheral blood finding in Splenic MZL?
A) Flower cells
B) Sézary cells
C) Villous lymphocytes
D) Reed-Sternberg cells

*Answer: C) Villous lymphocytes

*Question: What are the negative markers of Splenic MZL?
A) CD20, CD79a
B) CD103, Annexin A
C) CD5, CD10
D) CD23, CD38

*Answer: B) CD103, Annexin A

*Question: What is the treatment approach for asymptomatic advanced-stage Follicular Lymphoma?
A) Immediate R-CHOP
B) Watchful waiting or rituximab
C) HSCT
D) ABVD

*Answer: B) Watchful waiting or rituximab

*Question: What is the Lugano Stage II bulky criterion for abdominal mass?
A) ≥5 cm
B) ≥8 cm
C) ≥10 cm
D) ≥15 cm

*Answer: C) ≥10 cm

*Question: In DLBCL, which translocation is also seen in Follicular Lymphoma?
A) t(8;14) MYC
B) t(11;14) Cyclin D1
C) t(14;18) BCL2
D) t(9;22) BCR-ABL

*Answer: C) t(14;18) BCL2

*Question: Which lymphoma may arise as a transformation from SLL, FL, or MZL?
A) Burkitt Lymphoma
B) DLBCL
C) Mantle Cell Lymphoma
D) Follicular Lymphoma

*Answer: B) DLBCL

*Question: What is the DLBCL morphologic description?
A) Small cells with nuclear clefts
B) Cerebriform nucleus with scant cytoplasm
C) Pleomorphic large cells resembling leukemic blasts
D) Binucleated cells with owl-eye nucleoli

*Answer: C) Pleomorphic large cells resembling leukemic blasts

*Question: What percentage of DLBCL cases have MYC gene rearrangement?
A) 5%
B) 10%
C) 20%
D) 30%

*Answer: B) 10%

*Question: Which NHL has a leukemic phase defined by the presence of lymphoma cells in peripheral blood?
A) DLBCL only
B) Burkitt only
C) Multiple NHL subtypes including SLL, Burkitt, FL, MCL
D) Only T-cell lymphomas

*Answer: C) Multiple NHL subtypes including SLL, Burkitt, FL, MCL

*Question: What is the BCL6 mutation frequency in DLBCL?
A) 10%
B) 20%
C) 30%
D) 40%

*Answer: C) 30%

*Question: Which classic HL subtype is the most common?
A) Mixed cellularity
B) Lymphocyte rich
C) Lymphocyte depleted
D) Nodular sclerosis

*Answer: D) Nodular sclerosis

*Question: In NLPHL, mediastinal adenopathy is described as?
A) Very common
B) The hallmark presentation
C) Uncommon
D) Always present

*Answer: C) Uncommon

*Question: What is the incidence rate of Hodgkin Lymphoma?
A) 1.2 cases per 100,000 per year
B) 2.6 cases per 100,000 per year
C) 5.0 cases per 100,000 per year
D) 8.4 cases per 100,000 per year

*Answer: B) 2.6 cases per 100,000 per year

*Question: Which lymphoma is primarily associated with chronic antigen stimulation from infection or autoimmunity?
A) Follicular Lymphoma
B) Marginal Zone Lymphoma
C) Mantle Cell Lymphoma
D) DLBCL

*Answer: B) Marginal Zone Lymphoma

*Question: What is the molecular testing gold standard used for in lymphoma diagnosis?
A) Staging
B) Determining prognosis only
C) Diagnosing leukemias and lymphomas
D) Measuring tumor burden

*Answer: C) Diagnosing leukemias and lymphomas

*Question: Which FLIPI-2 factor replaces LDH from FLIPI-1?
A) Lymph node diameter >6 cm
B) Beta-2 microglobulin
C) Bone marrow violation
D) Performance status

*Answer: B) Beta-2 microglobulin

*Question: In Sézary Syndrome, the T-cell type is described as?
A) Effector memory T cells
B) Central memory T cells
C) Naïve T cells
D) Regulatory T cells

*Answer: B) Central memory T cells

*Question: What surface markers distinguish MF T cells from SS T cells?
A) MF is CCR7+; SS is CCR7-
B) MF is L-selectin+; SS is L-selectin-
C) MF is CCR7-, L-selectin-; SS is CCR7+, L-selectin+
D) Both have identical surface markers

*Answer: C) MF is CCR7-, L-selectin-; SS is CCR7+, L-selectin+

*Question: What is the role of FISH in lymphoma diagnosis?
A) Defines degree of maturation
B) Measures tumor burden
C) Detects chromosomal translocations
D) Determines clonality

*Answer: C) Detects chromosomal translocations

*Question: Which Burkitt Lymphoma subtype primarily involves blood and bone marrow?
A) Endemic
B) Sporadic
C) Immunodeficiency-associated
D) EBV-associated

*Answer: C) Immunodeficiency-associated

*Question: What is the Nodal MZL cell behavior in lymph nodes?
A) Paratrabecular distribution
B) Extend from mantle-marginal zone interface
C) Form starry sky pattern
D) Localize in Pautrier microabscesses

*Answer: B) Extend from mantle-marginal zone interface

*Question: What is a notable treatment concern specific to Hodgkin Lymphoma therapy?
A) Tumor lysis syndrome
B) Secondary malignancy
C) Graft versus host disease
D) Cytokine release syndrome

*Answer: B) Secondary malignancy

*Question: ALCL predominantly involves which organs at advanced stage?
A) Kidney and bladder
B) Lymph nodes, skin, bones, and soft tissues
C) Brain and spinal cord
D) Stomach and intestines

*Answer: B) Lymph nodes, skin, bones, and soft tissues

*Question: What percentage of DLBCL is curable with current treatment?
A) 1/3
B) 1/2
C) 2/3
D) 3/4

*Answer: C) 2/3

*Question: What percentage of childhood lymphomas does ALK+ ALCL represent?
A) 1-5%
B) 5-10%
C) 10-30%
D) 30-50%

*Answer: C) 10-30%

*Question: Which ATLL transmission route is NOT listed?
A) Transplacental
B) Breastfeeding
C) Airborne
D) Intercourse

*Answer: C) Airborne

*Question: For the IPI, what performance status score indicates adverse prognosis?
A) ≥ECOG 1
B) ≥ECOG 2
C) ≥ECOG 3
D) ≥ECOG 4

*Answer: B) ≥ECOG 2

*Question: Which NHL lymphoma is generally considered incurable with current therapies?
A) DLBCL
B) Burkitt Lymphoma
C) Follicular Lymphoma
D) Mantle Cell Lymphoma

*Answer: C) Follicular Lymphoma

*Question: What is the Lugano classification mediastinal mass criterion for Stage II bulky?
A) ≥1/3 of thorax diameter
B) ≥1/2 the internal transverse diameter of the thorax
C) ≥5 cm in diameter
D) Any visible mediastinal mass

*Answer: B) ≥1/2 the internal transverse diameter of the thorax

*Question: Which serum marker is used as an indirect measure of tumor burden in lymphoma workup?
A) CRP
B) ESR
C) LDH
D) Beta-HCG

*Answer: C) LDH

*Question: What is the MIPI used for?
A) Follicular Lymphoma prognosis
B) Mantle Cell Lymphoma prognosis
C) DLBCL prognosis
D) Hodgkin Lymphoma prognosis

*Answer: B) Mantle Cell Lymphoma prognosis